Healthcare Provider Details

I. General information

NPI: 1063336741
Provider Name (Legal Business Name): LAUREN MCDONOUGH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 STAGECOACH WAY
COHASSET MA
02025
US

IV. Provider business mailing address

42 CASPAR ST
WEST ROXBURY MA
02132-2429
US

V. Phone/Fax

Practice location:
  • Phone: 781-426-0977
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2359131
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: